Organization
CENLA DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HONEY R FIASCONARO DDS (PRESIDENT)
(318) 729-6205
Entity
Organization
Contact information
Practice address
3200 MONROE HWY, SUITE 150, PINEVILLE, LA 71360-8110
(318) 640-3200
Mailing address
3200 MONROE HWY, SUITE 150, PINEVILLE, LA 71360-8110
(318) 640-3200
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5754
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1871607895
NPI
LA
Enumeration date
10/07/2009
Last updated
10/07/2009
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